Topic Contents:

Cleft Lip - Treatment Overview

Surgery is always needed to treat
cleft lip, and sometimes multiple procedures are
needed over several years. Some treatments, such as speech therapy, may
continue into early adulthood.

Your child's doctor or a
health care team will examine your newborn before your
baby goes home from the hospital. These professionals can tell you how to care
for your child before surgery.

Before surgery

Sometimes cleft lip is treated with
presurgical supports, such as special dental splints, soft dental molding
inserts, or medical adhesive tape. A child with a cleft lip and
palate may be treated with presurgical
supports.

Surgical repair of cleft lip

When the surgery
takes place depends upon a number of things, including what your doctor
suggests, your baby's health, and the cleft itself. Most doctors agree that
cleft lip should, in most cases, be repaired by the time your baby is 3 to 6
months old.1

When deciding on the timing
and type of surgery needed to repair a cleft lip, the
doctor considers factors that relate to the
classification of the cleft and the baby's overall
condition. Such considerations include:

Whether the cleft is complete or incomplete.
A complete cleft lip is a deep split in the upper lip that extends into one or
both sides of the nose. An incomplete cleft lip affects only one side of the
upper lip and may appear as a slight indentation or as a deep notch. See a
picture that shows a complete cleft lip and an incomplete cleft lip.

How much of the lip is involved. A cleft lip can affect
one side of the upper lip (unilateral) or both sides
(bilateral).

Whether the baby has a
cleft palate or any defects of the nose. Usually, any
additional facial disfigurements make surgical treatment more
complex.

The size and health of the baby.

Whether it
is possible that the baby has a broader health condition.

After surgery

After surgery to correct a cleft
lip, your baby may need to wear a head bonnet across the upper lip and taped to
the cheeks, face, and head. The bonnet is made of a strap bandage reinforced
with wire. This device helps prevent the lip from stretching and protects the
stitches from breaking or separating. The head bonnet is worn for as long as it
takes your child's lip to heal.

Your baby's arm movements may be
restricted with splints or other material for as long as 3 weeks. This is
sometimes needed to prevent your baby from touching and damaging the
stitches.

After your baby's surgery, you will need to:

Take measures to prevent infection and
promote healing. Your health care team will offer guidance, but in general make
sure you keep the area clean and protect the lip from injury.

Make sure your child is eating and drinking well. Feeding by bottle or at the breast usually doesn't
require any special measures.

A health care team will closely monitor your child. It is a good idea to have a
children's (pediatric) dentist for your child's general dental care and to
consult an orthodontist as your child grows.

Usually the lip heals well after
surgery, with very little evidence of the cleft. Sometimes there is a slight
scar, but it is not usually very noticeable. Males usually develop normal
facial hair growth on their upper lip as they mature. Some males grow mustaches
to hide the scar. Females usually can cover the scar with makeup and lipstick.
Sometimes another lip surgery is needed at 4 or 5 years of age. And surgery on
the nose may not be done until adolescence.

Preventing cleft lip

Experts are still trying to
find answers about why some babies are born with cleft lip. Although sometimes
cleft lip is passed down through families (inherited), in most cases the cause
is not known. Research continues on how
genes and a mother's health—what she eats and drinks
and what hazards she is exposed to during pregnancy—can result in the
fetus developing cleft lip. Studies show that if you
smoke or drink alcohol during pregnancy, you may increase the risk that your
child will be born with a cleft lip and/or cleft palate.

Take good care of yourself before and during
pregnancy. You can do some things to help
prevent your fetus from developing cleft lip or cleft palate, such as taking prenatal vitamins and folic acid supplements. If
you are planning a pregnancy and you have neither previous family history of
cleft lip or palate nor a child with cleft lip or palate, taking 400 mcg (0.4 mg) of folic acid daily for 6 to 8 weeks is recommended. If you have a child
with a cleft lip or palate or if you have a family history of cleft lip or
palate, then 4 mg of folic acid daily for 6 to 8 weeks is recommended prior to
pregnancy.2 Taking folic acid requires a prescription
from your doctor.

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How this information was developed to help you make better health decisions

Related Articles

Cleft Lip - Symptoms
Feeding problems usually only occur in babies with cleft lip if they also have cleft palate. Usually cleft lip is not related to other health problems.

Types Of Cleft Lip
A unilateral cleft lip may cause the nostril on that side to be tilted and lower than the other nostril, and a bilateral cleft lip may cause the nose to be broader and shorter than normal.

Cleft Lip - Exams And Tests
If cleft lip occurs with cleft palate, it is sometimes associated with another health condition, such as fetal alcohol syndrome or chromosomal disorders.

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